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Oncology Outreach Nursing: Chemo, school liaison and much more

To the average person a nurse’s workplace is a hospital, but in reality it is a varied profession, and for Daphne Walshe being an Oncology Outreach Consultant means caring for patients in their homes in a multitude of Sydney suburbs.

When children return home after procedures or treatment in the Cancer Centre for Children at The Children’s Hospital at Westmead, they often need continuing specialised medical care.

Daphne, who is a registered nurse, provides much more than helping with needles, dressing changes and central line flushes though.

“I visit the children who are being treated in our oncology unit. That includes children with cancer or children following a bone marrow transplant,” said Daphne.

“I support them with hands-on nursing care and liaise with services, such as their local hospital if they need blood tests, and sometimes provide education in those centres as well, so the children get the care they need."

“The other thing I do is liaise with schools, pre-schools and day care centres so when it's safe for our patients to return they can. Even if they're not going to be at school for a certain period of time such as 3, 6, 9 or 12 months the school needs to have an understanding of what treatment entails for that child. Then they can support them in the best the best way possible until the child is ready to go back to school or to preschool.”

Daphne Walshe (centre) on a school visit with Back on Track and a child's teacher and class

School liaison takes place alongside the Back on Track (BoT) education programme, which provides educational support, and includes a joint visit involving Daphne, the BoT representative and the child’s teacher.

“During the visits I talk about the safety of the child medically and write up a healthcare plan so they can attend school. If they’ve got a suppressed immune system they might need a central line in place to make it safe for the child to be at school,” said Daphne.

Since 2003, when she first became a Community Outreach Nurse, Daphne’s car has been her office, although this wasn’t always the case.

“In the 1980s I worked in paediatric oncology in Camperdown and Westmead Hospitals, although I also trained in the adult field. I’ve always worked within paediatrics. It’s what I enjoy doing and what I’ve always enjoyed doing.”

“It’s my passion, I was drawn into oncology I suppose because there was always a great need for nurses in oncology. It’s a very challenging and rewarding field.”

Part of the challenge is keeping up to date with the medical field which is constantly evolving.

“When we trained, back in the day, we received a General Certificate of Nursing which was hospital-based training. I then studied to increase my qualifications to have a Bachelor of Nursing and a Graduate Certificate of Paediatric Oncology Nursing. After that I felt I needed to keep learning, so I went to UTS and got my master’s degree majoring in Paediatric Nursing Science. There are always new things to learn but the important thing is to retain that caring passion.”

Parents often appreciate Daphne’s home visits to help them understand how to assist their child away from the support of a hospital environment and to do procedures in their more comforting home setting.

“To visit a child at home, I usually get a request from either the medical or nursing staff in the clinic in the Oncology Treatment Centre, or in the ward if the child is being discharged. My days are really varied and can include blood tests, antibiotics if they just need one or two more doses, injections, some of the more simple and quick chemotherapies that can be done at home, anti-fungal medications, infusions, sometimes I insert catheters and feeding tubes, and I also support and educate parents, and other care givers, on a variety of things like show them how to do dressings. Each day is really varied.”

Working in the Cancer Centre as an Oncology Outreach Nurse means Daphne is supported by staff as passionate as she is. “I’m really proud of the culture at The Children’s Hospital at Westmead which is family centred with staff supporting families throughout their illness trajectory. We have caring and dedicated doctors and nurses in Oncology who genuinely care about patients and their families. It really is a truly meaningful job.”